On February 26th I had a med-check with my psychiatrist. The 10mg of Brintellix (an anti-depressant) was working, but historically February through April are my worst months for depression. Sam and I were having issues, money was tight, and Atticus was having significant behavior issues at school. These are all little things, but my Dr. and I thought it best to bump up the anti-depressant slightly since my last depressive bout was only in December. The next day I took my increased dosage of Brintellix and life was dandy for a few days.
About three days into my new dose I started to climb towards hypomania. I was terrified. I’m sure you’ve probably witnessed film portrayals of a “manic-depressive” wherein some quirky person is suddenly gleeful, fun, and brilliant during mania. While these characteristics are certainly part of the hypomania/mania package, it isn’t everything and each bipolar or bipolar II sufferer experiences hypomania/mania in vastly different ways. I knew I was hypomanic because I was riddled with acute anxiety. I couldn’t sleep and when I did sleep for a few hours I had vivid, reoccuring nightmares. During the day I startled easily and was restless. I would stop and start projects at work because I was so distracted. In addition to the physical restlessness I had pressured speech that jumped topics. Audiotory sensitivity was also an issue. Basically I could hear EVERYTHING. It was like someone turned up the volume on all white noise. Y’all, I could hear the lightbulbs humming. The most horrifying side effect was intense social anxiety. I’m not talking about being introverted, I’m talking about not wanting to leave the house, missing a committee meeting because I couldn’t walk into a room of people, and canceling a dentist appointment for a cleaning because the thought of the loud scraping and people bending over me in my face riddled me with fear. I’m exceedingly proud that I went to work each day with exception of one day I spent at home with Atticus after he had a dental procedure. It took every ounce of fortitude to leave my home and act like a functioning human. Daylight Savings time was just around the corner and I was completely aware that it would contribute to the problem and I was afraid I the hypomania would grow.
I lived in this state of anxiety for about a week and a half to give the recommended two weeks for the medicine to even out. After that, with my psychiatrists blessing, I stepped back down to the 10mg and I’ve been on that dosage for about a week. I’m back to feeling like myself again. I’m glad I was mindful of my symptoms and I didn’t get a full-blown hypomania episode like I did in November. See, hypomania or mania is always followed by a crash. One doesn’t go from hypomania to “typical.” Instead a depressive episode usually follows a hypomanic episode. In those of us with an illness on the bipolar spectrum anti-depressants can trigger hypomania or mania. Then you crash and the dose of anti-depressant is not enough to pull you out of the resulting depressive crash and upping anti-depressants are not an option because MANIA. Enter mood stabilizers like Lithium, Depakote, and Lamictal. I’ve had them all in the past and I royally hate them. For one there is massive water retention and weight gain and then a prevading sense of numbness to everyone and everything around you.
I mean, I’d go on mood stabilizers if my doctor thought it essential to my health, but right now I’m not in crisis. I’m no longer hypomanic and I’m not depressed. I’m STABLE, but to maintain that stability I have to self-care like a motherfucker.
In my view there are at least two types of self-care, emotional and physical. I am super good at emotional self-care. I see my therapist, I make time to be alone and spend time with family, I’ll do the guided meditations and the coloring pages, I will process and validate the hell out of my feelings and I’m a badass at journaling or blogging to cope and reflect. What I really suck at is physical self-care. Bipolar II is a biological disease. My brain is completely wired up differently. I will always have bipolar II disorder. There are chemical and biological machinations in my brain that require medication. However, I’ve been completely lax at doing the physical self-care I need to do to keep me from slipping back into instability, depression, and illness. Think of it this way. If I had diabetes I could take insulin and not do a damned thing else, but I might not be living the best life I could. If I had diabetes and took insulin, but then also took up healthy eating and excercise I WOULD THRIVE.
Thriving is a pretty appealing goal.
Of course this library gal was not content with what the internet provided as far as holistic bipolar management. Some whack jobs seem to think that supplements, kale, and yoga can CURE bipolar. Color me skeptical. I took my ass to my library’s medical research databases and found several articles from journals like The Journal of Biomedical Sceince, The Indian Journal of Psychological Medicine, and The Journal of Alternative & Complementary Medicine and read up on how to create a healthy lifestyle when one has bipolar disorder. I mostly stuck to reading the abstracts, but I learned so much.
Long story short, my diet and lifestyle are screwing me over in the mental health department. When I went back to being an omnivore last summer it was add some variety to my diet. Instead I went back to bread, fast food, sugary treats, tons of coffee and precious few vegetables and fruits. After some academic research I took myself to Pinterest and for several days I pinned healthy recipes chockfull of nutrient-dense food. I decided to go about 80% vegetarian because I simply choose better food when I’m eating vegetarian. I have chicken or fish in the meal plan, but most of my meals are vegetarian. Belly dance or walking for daytime exercise and YouTube yoga at night. B-12 in the morning, fish oil in the afternoon, and a probiotic several times a day. 8 to 10 cups of water and no more than two cups of coffee.
It has only been a week, but I feel better. I’m enjoying cooking (and eating)! Sam’s blood pressure went back up when we went back to being omnivores, so this change will be good for the entire family. Expect to see an occasional health check-in and perhaps some recipes. Cross your fingers this healthy lifestyle sticks and keeps me off the mood stablizers!